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  2. CQM-6447

Is it ever appropriate for a preliminary result to satisfy CMS 130?

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    • Icon: EC eCQMs EC eCQMs
    • Resolution: Answered
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    • Jennifer Bailey
    • 2692091585
    • Trinity Health
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      Thank you for your inquiry about CMS130v12: Colorectal Cancer Screening. Applicable screenings to meet the numerator criteria may include; Fecal Occult Blood Test, Stool DNA with Fecal Immunochemical Test (FIT), Flexible Sigmoidoscopy, CT Colonography, or a colonoscopy. The applicable screenings mentioned above may count towards the numerator when performed within the measurement period and/or within the time frame indicated. A result is not required for the flexible sigmoidoscopy, colonoscopy, or CT colonography. A "non-null" result is required for screening options such as FOBT and Stool DNA with FIT laboratory tests. An insufficient sample may count towards numerator since a non-null result can be interpreted as a result that is present in the electronic record in which any entry is acceptable; no specific value or code is required. Equivalent services can be mapped to the measure's value sets. If mapping is done, you should maintain documentation in case of a CMS audit.
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      Thank you for your inquiry about CMS130v12: Colorectal Cancer Screening. Applicable screenings to meet the numerator criteria may include; Fecal Occult Blood Test, Stool DNA with Fecal Immunochemical Test (FIT), Flexible Sigmoidoscopy, CT Colonography, or a colonoscopy. The applicable screenings mentioned above may count towards the numerator when performed within the measurement period and/or within the time frame indicated. A result is not required for the flexible sigmoidoscopy, colonoscopy, or CT colonography. A "non-null" result is required for screening options such as FOBT and Stool DNA with FIT laboratory tests. An insufficient sample may count towards numerator since a non-null result can be interpreted as a result that is present in the electronic record in which any entry is acceptable; no specific value or code is required. Equivalent services can be mapped to the measure's value sets. If mapping is done, you should maintain documentation in case of a CMS audit.
    • Not measure related
    • CMS0130v12
    • Not measure related
    • CMS0130v11
    • Our Epic EHR vendor is currently using preliminary result "insufficient sample" to satisfy the measure. We are requesting confirmation from CMS that the preliminary result "insufficient sample" should not satisfy CMS eCQM 130.

      Trinity Health would like to inquire whether it is ever appropriate for a preliminary result to satisfy CMS quality measure 130. We are aware that Exact Sciences, the makers of Cologuard, report preliminary results for insufficient samples as negative until a repeat test with a confirmed result is completed. While the screening is performed, we believe the intent of the measure is to have a definitive result before the quality measure is satisfied. Your confirmation of our understanding of the measure intent is appreciated.

            edave Mathematica EC eCQM Team
            baileyjl1 Jennifer Bailey
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